Is Spinal Stenosis a Serious Condition?
Spinal stenosis is narrowing of the spinal canal or spinal neve root foramen (hole). Spinal stenosis can compress the spinal cord and nerves which can lead to pain, numbness and weakness in your legs or hips (lumbar stenosis) or neck and shoulders (cervical stenosis). Spinal stenosis can affect any part of the spine however most commonly it affects the lower back (lumbar stenosis, lumbar canal stenosis and lumbar foraminal stenosis).
What causes spinal stenosis?
Spinal stenosis usually results from age-related conditions and therefore typically affects people aged 40 or above. Causes include:
- wear and tear in the spine, including overgrown ligament or bone (osteoarthritis or spondylosis);
- disc herniation (also known as disc protrusion or slipped disc);
What are the symptoms of lumbar spinal stenosis?
One of the most common symptoms of lumbar canal stenosis is neurogenic claudication: pain, numbness or weakness in one or both buttocks or legs after walking or standing for any length of time. Lumbar spinal stenosis can also cause pain in the lower back, weakness, numbness, and/or pins and needles and/or other sensory disturbance in the legs or feet; numbness or sensory disturbance affecting the groin, perineum and genital region; and/or a change in bladder or bowel function.
What types of non-surgical treatments are available?
Depending on your symptoms and your medical history, conservative non-operative treatment might be recommended initially to try and relieve symptoms of spinal stenosis. If you have severe pain, limb numbness or weakness, or significant neurological deficits such as loss of normal bowel or bladder function, surgery may be the first and safest option.
Conservative treatment options for spinal stenosis include:
- remaining active and undertaking low-impact exercise which including walking, stretching, swimming, yoga and Pilates;
- optimising your posture, weight and diet;
- pain relief tablets: using over the counter painkillers and anti-inflammatory medication such as paracetamol or ibuprofen or specific nerve pain relief such as pregabalin or amitriptyline;
- CT-guided injections (typically with a combination of local anaesthetic and steroid);
- alternative treatments such as topical creams, hot and cold compresses, TENS machines, acupuncture, memory foam pillows and mattresses.
Is spinal stenosis a serious condition?
Spinal stenosis, when it becomes severe, can cause cauda equina syndrome – a rare but serious condition requiring immediate treatment. If the nerves in the lower back are severely compressed by the narrowing of the spinal canal it can cause the following symptoms:
- sciatica on both sides;
- weakness or numbness in both legs that is severe or getting worse
- numbness around or under your buttocks or your groin area
- a change in bladder function (such as loss of bladder control) or
- a change in bowel function (such as being unable to control bowel functions or know when you are experiencing a bowel function)
The longer it is left untreated the greater the chance it can lead to permanent incontinence and/or paralysis and if you have any of these symptoms you should seek immediate medical attention.
Does spinal stenosis require surgery?
Spinal stenosis may be treated conservatively and, therefore, does not always require surgery. However, if a patient has tried non-surgical treatments without success, is in severe pain or has significant neurological deficit, surgery will usually be recommended.
The primary goal of spinal surgery for patients with spinal stenosis is to reduce symptoms and improve the chance of recovery. It is very effective in reducing pain and gives the best chance for weakness and numbness to recover.
The surgical procedure performed aims to decompress the spinal cord/nerves by increasing the availability of space for the patient’s spinal cord and spinal nerves. Decompression is achieved through a laminectomy, foraminotomy or a microdiscectomy depending on the cause and location of the spinal stenosis.
In some cases, spinal stabilisation (fusion) surgery may be recommended in order to optimise decompression and limit symptoms from spinal instability.
Sydney Spine Surgeon
If you are concerned about any symptoms you have, do contact our friendly team today to book an appointment to see Dr James Laban on (02) 8320 0577.
Dr Laban is a fellow of the Royal Australasian College of Surgeons and of the Royal College of Surgeons of England and has trained, worked, published and presented nationally and internationally. Dr Laban is a specialist spinal surgeon with expertise in spinal stenosis. Dr Laban is a Sydney neyrosurgeon and Sydney spine surgeon who works out of his North Shore, Northern Beaches and Central Coast consulting rooms. We are open to talk to you between the hours of 8:00am 5:00pm, Monday to Friday.